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Biomedical subjects

P Buchmann

Publications and source records attributed to P Buchmann.

At least 145 records · Page 8Linked to original sources
PubMed1980

[Continent external duodenal fistula in the dog (author's transl)].

An established method for the experimental approach to the duodenum in the dog is the interposition of a segment of small bowel. However, the leakage of intestinal fluid causes unpleasant side effects. By the invagination within the intestinal segment as valve can be constructed which provides both continence and easy access.

Animals↗
PubMed1980

Perianal Crohn's disease.

Perianal disease is a frequent manifestation of Crohn's disease and occasionally is the presenting symptom. However, most lesions are or become asymptomatic and remain so for many years. A series of 109 patients with perianal fissures and fistulas has baeen followed for 10 years. Fourteen have died, 7 from unrelated disorders. Ten have had an excision of the rectum but only 5 for perianal disease. Of the remaininga 85 patients, 24 asymptomatic patients were not re-examined, and 61 were investigated extensively by sigmoidoscopy biopsy or manometry. Many fissures and most fistulas had healed, but some had progressed to some degree of anal stenosis, usually asymptomatic. A very conservative policy is proposed.

Abscess↗
PubMed1980

Natural history of perianal Crohn's disease. Ten year follow-up: a plea for conservatism.

A 10 year follow-up of 109 patients with histologic Crohn's disease and anal lesions is reported. Fourteen patients (13 percent) have died, 7 from unrelated disorders. Ten required excision of the rectum, but only 5 for perianal disease (4.5 percent). Of the remaining 85 patients, 61 have been followed up to proctoscopy and rectal biopsy. Anal skin tags were still evident in 25 of 37 patients (68 percent), but new tags have appeared in only 2 patients. Ten of 53 fissures (19 percent) were still present at 10 years, and there were no new fissures. Seven of 21 patients (33 percent) still had fistulas but were asymptomatic; the remainder of the fistulas had healed spontaneously (8) or after operation (6). New fistulas have appeared in five patients. None of the patients have been in continent. These results indicate that perianal manifestations of Crohn's disease pursue a relatively benign course and are rarely an indication for proctectomy.

Adult↗
PubMed1980

Carcinoma in a rectovaginal fistula in a patient with Crohn's disease.

A patient with Crohn's disease underwent resection for internal fistulas. Later a rectovaginal fistula developed that persisted with minimal symptoms for 10 years before causing pain and induration in the posterior vaginal wall, due to carcinoma developing within the fistula.

Adenocarcinoma, Mucinous↗
PubMed1980

Relationship of proctitis and rectal capacity in Crohn's disease.

In patients with Crohn's disease involving the rectum (n=25), there was an inverse relationship between rectal capacity and the degree of proctitis. However, in patients with Crohn's disease not involving the rectum (n=22) the rectal capacity was similar to that of normal controls (n=20). The frequency of defaecation was not related to the degree of proctitis or to the pressure of a colectomy and ileorectal anastomosis. Control subjects had a significantly lower frequency of defaecation than patients with Crohn's disease irrespective of involvement of the rectum.

Adolescent↗
PubMed1980

[Experience with the EEA stapler in colon anastomosis].

On the basis of 35 resections of the sigma of low anterior resections of the rectum, the outcome of conventional (13) and EEA stapler (22) anastomoses is analysed. The incidence of clinical or radiological insufficiencies is significantly lower in stapler anastomoses. Technical details important for a successful stapling procedure and the outcome of the anastomosis are discussed. The importance of the control for completeness of the tissue rings after removal of the purse-string suture is stressed. Regarding these technical details stapler anastomoses have proven to facilitate very low anterior rectal resections and to achieve less postoperative complications.

Aged↗
PubMed1979

Prospective trials of minor surgical procedures and high-fibre diet for haemorrhoids.

Two hundred and sixteen consecutive patients seen for the first time with symptomatic haemorrhoids entered trials of conservative and minor surgical treatment. They were divided into two groups according to their pretreatment maximal anal pressure. Patients with pressures of 100 cm H2O (73.7 mm Hg) or more (108 patients) were treated by anal dilatation (37), sphincterotomy (34), or high-fibre diet (37). Four and 12 months later anal dilatation had produced significantly better results than sphincterotomy or diet. Furthermore, anal dilatation was the only treatment associated with a significant reduction in anal pressure at four and 12 months. Patients with pressures under 100 cm H2O (108 patients) were treated by rubber-band ligation (35), cryosurgery (36), or diet (37). Four and 12 months later significantly more patients were improved by rubber-band ligation than by cryosurgery or diet. These results suggest that haemorrhoids in patients with excessive activity of the internal anal sphincter are best treated by anal dilatation and that in all other patients rubber-band ligation is the treatment of choice.

Adult↗
PubMed1978

[Side effects of proximal selection vagotomy on the esophagus. I. Effects on the esophageal blood circulation (author's transl)].

The influence of the proximal selective vagotomy (PSV) with following skeletisation of parts of the esophagus on its circulation was investigated in an animal experimental study. Among the 6 dogs with PSV and skeletisation of the esophagus up to the upper thorax apertura one was seen with necrosis and perforation in the distal part of the esophagus. The last 5 dogs and the 4 dogs in which after the PSV only the denudation of the distal part of the esophagus was carried out no signs of circulatory disturbance were seen. The blood circulation in human esophagus, as described in the literature, and the transfer of the results from dogs to human is discussed. An enlarged skeletisation of the esophagus in order to improve the completeness of the PSV does not harm blood circulation.

Animals↗
PubMed1978

[Side effects of proximal selective vagotomy on the esophagus. II. Experimental study of effects of the esophageal motility and the lower esophageal sphincter (author's transl)].

The influence of the proximal selective vagotomy (PSV) with mobilisation of the esophagus of 6 cm or up to the upper thorax apertura on esophageal motility in a first group and mobilisation of 2 or 7 cm on the lower esophageal sphincter tone in a second group was investigated in canine experiments. The loss of coordinated peristalsis in the denuded segment causes a deterioration of esophageal passage. The degree of disturbance of swallowing depends on the length of the mobilisation. Reduction of lower esophageal pressure was observed. These reduction was not influenced by the extent of this motilisation. Acid reflux was not seen. Due to anatomical differences between these two species, these results cannot be readely transferred to human. Enlarged mobilisation of the esophagus for completion of PSV cannot be recommanded without reservation. Clinical studies are needed.

Animals↗
PubMed1977

[An additional use of the small intestinal invagination valve].

Extensive small intestine resection (70--90%) as should be done after mesenteric infarction produces a chronic malabsorption syndrome with its consequences. Applying an invagination valve of the small intestine (Kock) and using the isoperistaltic modification, passage of the chyme is delayed and its resorption improved. A small intestine resection of 90% was done in 8 mongrel dogs. After an average of 2--3 months an obvious cachexia as well as a steatorrhea could be observed. By adapting an isoperistaltic small intestine invagination valve near the colon weight reduction could be stopped during another 6 months and the steatorrhea disappeared No ileus occured.

Animals↗
PubMed1976

[Studies on the heredity and pathogenesis of familial combined hyperlipidemia ("multiple lipoprotein type" hyperlipidemia)].

A family with familial combined hyperlipidemia (multiple-lipoprotein type hyperlipidemia) was investigated with regard to mode of inheritance, phenotypic expression, presence of genetic markers, and biochemical parameters related to lipid metabolism. The family of 22 subjects (13 males, 9 females) was composed of 5 type IIa, 8 type IIb, 1 type IV hyperlipoproteinemias and 5 normolipidemics. The distribution of serum cholesterol and serum triglyceride concentration was bimodal. No relationship was observed between hyperlipidemia and blood groups or histocompatibility antigens. Subjects with high HLA 8 or W 15 had, on the average, higher lipid levels than others. However, these antigens were observed in normolipidemics too. The response to therapy with alufibrate (2g/day) was not uniform. Subjects with marked triglyceride lowering exhibited only moderate cholesterol lowering, and marked cholesterol lowering was associated with poor triglyceride lowering. The reduction in serum lipids was observed in unaffected family members as well. It is therefore concluded that alufibrate does not exert an effect on the defect in familial combined hyperlipidemia but on some unspecific sites probably on lipoprotein lipase. The familial combined hyperlipidemia appears to be transmitted in an autosomal dominant mode and very probably determined by more than one gene.

Adolescent↗
PubMed1976

[Silicone rubber-- an unsuitable and dangerous material for T-drains].

Four cases of bile peritonitis after removal of silastic T-tubes are described. The removal of the tubes took place 8 to 23 days after operation. This complication has been described only since the introduction of silastic tubing. The therapy consists in early relaparotomy and drainage. In dogs, the behavior of intraperitoneal silastic and rubber tubes was compared. Whereas rubber tubing was completely surrounded by a fibrous sheet not later than 2 weeks after implantation, the silastic tubing was floating freely in the abdominal cavity even after 6 weeks. Therefore, the use of silastic tubes is dangerous in short-time bile duct drainage. On the other hand, this material had advantages for long-term drainage and for endoluminal prostheses.

Adult↗
PubMed1976

[Results with the second kidney transplantation].

330 kidneyallotransplantations were performed between 1965-1975 at the Surgical Clinic A of Zurich University Hospital, thereof 31 second set grafts. The one-year-survival rate of the second set recipients was 67% and that of the second set grafts 54%. From our more recent cases we can conclude, that even better results were possible, if retransplantation were planed and attempted an earlier state of graft failure.

Adult↗